Our Summary

This research paper discusses various methods for treating conditions in the finger joints, such as osteoarthritis and inflammatory arthritis. Two main treatments include joint fusion and arthroplasty (joint replacement). Joint fusion is suggested for patients with painful finger joints, regardless of how healthy the soft tissue around the joint is.

On the other hand, implant arthroplasty is recommended for elderly patients suffering from degenerative or inflammatory arthritis, though these implants may need to be replaced in the future. Another option, arthroplasty using a patient’s own cartilage graft, is a good option for younger patients with arthritis caused by injury in certain joints of the hand. However, vascular joint transfers are rarely used.

The paper emphasizes that doctors need to carefully assess each patient’s specific condition and what they hope to achieve with treatment.

FAQs

  1. Who are the ideal candidates for joint fusion surgery?
  2. Under what conditions is implant arthroplasty recommended for patients with arthritis?
  3. What are some alternative treatments for young patients with posttraumatic metacarpophalangeal or proximal interphalangeal joint osteoarthritis?

Doctor’s Tip

A doctor may tell a patient considering joint fusion that it is a surgical procedure where the ends of the bones in a joint are fused together to reduce pain and improve function. It is important for the patient to understand that joint fusion may limit some range of motion in the affected joint, but it can provide long-term pain relief and stability. The doctor may also discuss the importance of following post-operative rehabilitation and physical therapy to ensure a successful outcome.

Suitable For

Patients who are typically recommended joint fusion are those with painful finger joints, with or without poor soft tissue condition. This includes patients with osteoarthritis and inflammatory arthritis. Joint fusion is a good option for these patients as it can help improve hand function and alleviate pain. Additionally, joint fusion is often recommended for younger patients with posttraumatic metacarpophalangeal or proximal interphalangeal joint osteoarthritis.

It is important for surgeons to carefully assess each patient’s condition and treatment expectations before recommending joint fusion. Patients who may not be suitable candidates for joint fusion include elderly patients with degenerative or inflammatory arthritis, as implant arthroplasty may be a better option for them. Vascular joint transfers are rarely used and may not be recommended for most patients. Ultimately, the decision to recommend joint fusion will depend on the individual patient’s specific condition and needs.

Timeline

Before joint fusion:

  1. Patient experiences pain and stiffness in the affected joint.
  2. Patient may have difficulty performing daily activities and tasks.
  3. Patient may have tried conservative treatments such as medication, physical therapy, and injections without success.
  4. Patient undergoes diagnostic tests such as X-rays or MRI to determine the extent of joint damage.
  5. Surgeon recommends joint fusion as a treatment option for severe joint damage and pain.

After joint fusion:

  1. Patient undergoes pre-operative evaluation and preparation for surgery.
  2. Surgeon performs joint fusion surgery by removing the damaged joint surfaces and fusing the bones together using screws, plates, or rods.
  3. Patient goes through a period of post-operative recovery and rehabilitation, which may include physical therapy to regain strength and range of motion.
  4. Patient experiences a decrease in pain and improvement in joint stability after the fusion has healed.
  5. Patient may need to adjust to limitations in joint movement and function due to the fused joint.
  6. Long-term follow-up appointments are scheduled to monitor the fusion and assess the patient’s overall hand function.

What to Ask Your Doctor

  1. What is joint fusion and how does it differ from arthroplasty?
  2. What are the indications for joint fusion in treating finger joint disorders?
  3. What are the potential risks and complications associated with joint fusion?
  4. How long is the recovery period after joint fusion surgery?
  5. Will I need physical therapy after joint fusion surgery?
  6. What are the expected outcomes and success rates of joint fusion surgery?
  7. Are there any alternative treatments to joint fusion that I should consider?
  8. How long can I expect the results of joint fusion surgery to last?
  9. Will I still be able to perform daily activities and participate in sports or physical activities after joint fusion surgery?
  10. Are there any restrictions or limitations I should be aware of after undergoing joint fusion surgery?

Reference

Authors: Yamamoto M, Chung KC. Journal: Clin Plast Surg. 2019 Jul;46(3):479-488. doi: 10.1016/j.cps.2019.03.008. Epub 2019 Apr 12. PMID: 31103091